MODEL WATER EFFICIENT LANDSCAPE ORDINANCE (MWELO) SHORT FORM PRESCRIPTIVE COMPLIANCE Applicant Information: Name: ___________________________________________________________________________ Phone: ___________________________________________________________________________ Address: __________________________________________________________________________ Email: ____________________________________________________________________________ Project Site Address: _______________________________________________________________________ Project Type (new dwelling, commercial, or rehab): _________________________________________ This project does incorporate landscaping equal to or less than 2500 sq ft and will be using this form to identify prescriptive requirements which will be included as part of the landscape project. (Please provide the information below specific to the landscape area and identify the location on the plans each design measure can be found using the LANDSCAPE WATER-EFFICIENCY (MWELO) APPENDIX – D CHECKLIST on page two): Total Landscape Area (sq. ft.): ________________ Turf Area (sq. ft.): __________________________ Non-Turf Plan Area (sq. ft.): __________________ Special Landscape Area (sq. ft.): ______________ Water Type (potable, recycled, well):________________________________________ Name of water purveyor (If not served by private well):___________________________ Signature I certify the above information is correct and agree to comply with the requirements of the MWELO. ______________________________________________ Signature of property owner or authorized representative ______________ Date LANDSCAPE WATER-EFFICIENCY (MWELO) APPENDIX – D CHECKLIST (Can only be used when aggregate landscape areas are 2,500 square feet or less) Landscape Parameter Compost Plant Water Use Mulch Turf Irrigation System Location on Plans Design Measures Incorporate compost at a rate of at least four (4) cubic yards per 1,000 sq. ft. to a depth of 6 inches into landscape area (unless contra-indicated by a soil test). Residential: Install climate adapted plants that require occasional, little or no summer water (average WUCOLS plant factor 0.3) for 75% of the plant area excluding edibles and areas using recycled water. Non-residential: Install climate adapted plants that require occasional, little or no summer water (average WUCOLS plant factor 0.3) for 100% of the plant area excluding edibles and areas using recycled water. A minimum 3-inch layer of mulch should be applied on all exposed soil surfaces of planting areas, except in areas of turf or creeping or rooting groundcovers. Total turf area shall not exceed 25% of the landscape area. Turf is not allowed in non-residential projects. Turf (if utilized) is limited to slopes not exceeding 25% and is not used in parkways less than 10 feet in width. Turf, if utilized in parkways is irrigated by sub-surface irrigation or other technology that prevents overspray or runoff. Irrigation controllers use evapotranspiration or soil moisture data and utilize a rain sensor. Irrigation controller programming data will not be lost due to an interruption in the primary power source. Areas less than 10 feet in any direction utilize sub-surface irrigation or other technology that prevents overspray or runoff. A private landscape submeter is installed at non-residential landscape areas of 1,000 sq. ft. or more. Signature I agree to comply with the requirements of the prescriptive compliance option of the MWELO per Appendix D. ______________________________________________ Signature of property owner or authorized representative ______________ Date Note For the purposes of this for landscape area includes all the planting areas, turf areas, and water features in a landscape design plan subject to the Maximum Applied Water Allowance calculation. The landscape area does not include footprints of buildings or structures, sidewalks, driveways, parking lots, decks, patios, gravel or stone walks, other pervious or non-pervious hardscapes, and other non-irrigated areas designated for non-development (e.g., open spaces and existing native vegetation).